Fatal Hemorrhage From a Ruptured Aneurysm of a Submucosal Gastric Artery

Abstract A 47-year-old man was found unconscious after experiencing severe hematemesis. He had a history of alcohol abuse, hepatic cirrhosis, and previous episodes of gastrointestinal bleeding. Imaging studies indicated that the left gastric artery was the probable source of bleeding. A severe coagulopathy was also noted clinically. Angiographic embolization of the left gastric artery failed to staunch bleeding, and the patient died shortly after admission. Autopsy demonstrated a large, ulcerated epiphrenic esophageal pseudodiverticulum, the base of which was in close proximity to an esophageal branch of the left gastric artery. Cystic dilatation of adjacent esophageal submucosal glands was also seen. Gelatin embolic material, without associated thrombus formation, was found within the left gastric artery. Esophageal pseudodiverticulosis is an uncommon disorder that may be associated with dysphagia, stricture, and odynophagia. Bleeding and perforation are very rare complications. This case may be the first fatality proven by autopsy to be secondary to esophageal pseudodiverticulosis.

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Penetrating atherosclerotic ulcer aneurysm of the innominate artery

VASA ◽

10.1024/0301-1526.38.3.263 ◽

2009 ◽

Vol 38 (3) ◽

pp. 263-266 ◽

Cited By ~ 1

Author(s):

Yuan ◽

Tager

Keyword(s):

Conservative Treatment ◽

Thoracic Aorta ◽

Open Surgery ◽

Innominate Artery ◽

Ruptured Aneurysm ◽

Descending Thoracic Aorta ◽

Penetrating Atherosclerotic Ulcer ◽

Descending Aorta

Penetrating atherosclerotic ulcer of the aorta is uncommon, and usually develops in the descending thoracic aorta. Rarely this condition involves the branch vessels of the aorta. We report a case of ruptured aneurysm of the innominate artery resulting from penetrating atherosclerotic ulcer. Open surgery was the treatment of choice for the ruptured aneurysm, while conservative treatment was recommended for the associated penetrating atherosclerotic ulcers of the descending aorta.

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Emergent thoracic endovascular aortic aneurysm repair for ruptured aneurysm: in-hospital and long-term results

The Journal of Cardiovascular Surgery ◽

10.23736/s0021-9509.20.11595-7 ◽

2021 ◽

Vol 61 (6) ◽

Author(s):

Priya B. Patel ◽

Marc L. Schermerhorn

Keyword(s):

Aortic Aneurysm ◽

Long Term Results ◽

Ruptured Aneurysm ◽

Endovascular Aortic Aneurysm Repair ◽

Aneurysm Repair ◽

Aortic Aneurysm Repair

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Transcatheter Chemoembolization of a Hepatocellular Carcinoma Utilizing Lipiodol through the Pancreaticoduodenal Arcade: A Case Report

American Journal of Interventional Radiology ◽

10.25259/ajir-19-2018 ◽

2018 ◽

Vol 2 ◽

pp. 5

Author(s):

Scott P Patterson ◽

Richard G Foster

Keyword(s):

Hepatocellular Carcinoma ◽

Case Report ◽

Vascular Anatomy ◽

Left Gastric Artery ◽

Target Lesion ◽

Celiac Artery ◽

Small Hepatocellular Carcinoma ◽

Gastric Artery ◽

Variant Anatomy ◽

Pancreaticoduodenal Arcade

This case report describes the chemoembolization of a small hepatocellular carcinoma employing a lipiodol drug delivery system utilizing a novel arterial pathway. Because the target lesion was precariously located adjacent to the inferior heart border and the diaphragm, it was unsuitable for imaging-guided microwave ablation. To achieve chemoembolization, several intraprocedural adaptations were necessary, given the variant anatomy encountered and difficulty accessing the left gastric artery through a celiac artery approach. The left gastric artery was selected from a superior mesenteric artery approach through the pancreaticoduodenal arcade (Rio Branco’s arcade). This case illustrates the importance of a mastery of the vascular anatomy and variants of hepatic arterial flow.

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Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01466-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xuan Liu ◽

Leilei Wu ◽

Dongkun Zhang ◽

Peng Lin ◽

Hao Long ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Left Gastric Artery ◽

Prognostic Impact ◽

Gastric Artery ◽

Term Survival

Abstract Background Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC. Methods This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status. Results LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P < 0.001). Conclusions This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

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